Ins/rpl pm gen exist dual lead at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$11,437.35
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$26,023.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$688.49 with KARNA vs $63,824.00 with UNITED HEALTHCARE — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| KARNA | MEDICARE ADVANTAGE | $688.49 | ↓ -94% |
| CLOVER | MEDICARE ADVANTAGE | $4,684.14 | ↓ -59% |
| AETNA | MANAGED MEDICAID | $4,814.26 | ↓ -58% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $5,334.72 | ↓ -53% |
| WELLCARE | MANAGED MEDICAID | $11,437.35 | ↑ +0% |
| VACCN | ALL PRODUCTS | $11,437.35 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $11,437.35 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $11,437.35 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $12,009.22 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $12,466.71 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $13,724.82 | ↑ +20% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $15,327.55 | ↑ +34% |
| HORIZON | MANAGED MEDICAID | $16,493.38 | ↑ +44% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $16,654.72 | ↑ +46% |
| HORIZON | PIP | $16,940.97 | ↑ +48% |
| HORIZON | WORKERS COMP | $17,484.85 | ↑ +53% |
| HORIZON | OMNIA | $18,791.21 | ↑ +64% |
| BERGEN RISK | ALL PRODUCTS | $19,517.25 | ↑ +71% |
| AETNA | ASA | $20,376.01 | ↑ +78% |
| CIGNA | BH | $20,818.40 | ↑ +82% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $22,119.55 | ↑ +93% |
| HORIZON | SHP | $22,338.14 | ↑ +95% |
| AMERIHEALTH | LOCAL HMO | $22,598.37 | ↑ +98% |
| HORIZON | INDEMNITY | $23,160.47 | ↑ +102% |
| HORIZON | HMO | $23,176.08 | ↑ +103% |
| AETNA | HMO | $23,425.90 | ↑ +105% |
| AETNA | PPO | $23,425.90 | ↑ +105% |
| QUALCARE | PPO | $23,628.88 | ↑ +107% |
| QUALCARE | WORKERS COMP | $23,628.88 | ↑ +107% |
| QUALCARE | HMO | $23,628.88 | ↑ +107% |
| HORIZON | PPO | $23,790.23 | ↑ +108% |
| CIGNA | PPO | $24,885.79 | ↑ +118% |
| CIGNA | HMO | $24,885.79 | ↑ +118% |
| AMERIHEALTH | REGIONAL HMO | $25,596.22 | ↑ +124% |
| OXFORD | ALL PRODUCTS | $62,603.00 | ↑ +447% |
| UNITED HEALTHCARE | HMO | $63,824.00 | ↑ +458% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm gen exist dual lead at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $169.39 – $22,874.70 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $375.53 – $23,482.52 |
| Community Medical Center | Toms River | $3,786.00 | $384.57 – $22,760.33 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $371.00 – $23,365.11 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $174.37 – $23,482.52 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $219.21 – $24,525.95 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $742.00 – $23,051.48 |
| Bayshore Medical Center | Holmdel | $11,583.66 | $11,583.66 – $13,900.39 |